New Patient Intake Form

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Please take about 20 minutes to complete this intake form. Every question is required to answer. Please put N/A if the question does not apply to you.

Requirements before your New Patient Visit

Have you booked your New Patient visit and 2-3 other followup visits? Go to https://ahcc.as.me/ to schedule. *

Yes

Have you completed your insurance verification form if you plan to use insurance to cover your visit costs? Dr. Taylor is in network with BCBS, and if you have acupuncture coverage with another insurance provider (GEHA, etc), we can bill them as well. Use this link. *

Yes

Have you printed out these additional forms, read them, and signed? *

Yes

I will get the paper forms from the office when I come in

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